Ribavirin is an antiviral medicine indicated for the treatment of chronic hepatitis C that works by preventing the hepatitis C virus from multiplying, but it is not effective when used alone, and therefore must be taken in combination with interferon alfa or peginterferon alfa.
This medicine is provided by the SUS in the form of 250 mg capsules, with the generic name ribavirin or the commercial name Virazole.
The use of ribavirin should only be done under the guidance of a doctor, as it can cause side effects such as anemia or fetal malformations if used during pregnancy or if a pregnancy occurs during treatment.
What is it for
Ribavirin is indicated for the treatment of chronic hepatitis C in adults and children over 3 years of age, in combination with interferon alfa or peginterferon alfa, and should not be used alone.
Additionally, ribavirin is indicated for the treatment of liver cirrhosis caused by the hepatitis C virus, or after liver transplantation in people with hepatitis C.
How to drink
The recommended dose varies according to the person’s age, weight and the medicine used together with ribavirin. When there is no specific recommendation, the general guidelines indicate:
- Adults weighing less than 75 kg: the recommended dose is 500 to 1000 mg per day, divided into 2 doses, taken every 12 hours, preferably in the morning and evening;
- Adults over 75 kg: the recommended dose is 1250 mg per day, divided into 2 doses, taken every 12 hours, preferably in the morning and evening;
- Children over 3 years old: The recommended dose is 10 mg per kg of body weight per day, divided into 2 doses, taken every 12 hours, and must be calculated by the pediatrician.
The duration of treatment varies according to medical assessment and, generally, ribavirin is used for a period of 6 to 12 months of treatment.
It is important to drink plenty of fluids during ribavirin treatment to avoid dehydration of the body. In addition, blood tests must be carried out every 15 days to assess the amount of hemoglobin in the blood, as ribavirin can cause hemolytic anemia.
Ribavirin should be taken orally, with a glass of water, along with a meal, at the times established by the hepatologist. However, if you forget to take a dose on time, take it as soon as you remember, but you should skip the missed dose if it is time for your next dose. Do not take two doses at the same time to make up for a missed dose.
Possible side effects
The main side effects associated with the use of ribavirin are:
- Nausea;
- Vomiting;
- Loss of appetite;
- Diarrhea;
- Dor abdominal;
- Fever;
- Chill;
- Tremor;
- Excessive tiredness or weakness;
- Headache;
- Muscle pain;
- Change of mood;
- Depression and/or anxiety;
- Dry mouth, increasing the risk of cavities or gum changes.
Ribavirin can also increase the risk of hemolytic anemia, which can be confirmed through a blood test that must be carried out every 15 days during treatment, and through symptoms such as paleness in the mucous membranes of the eyes and mouth, hair loss, difficulty in breathing or yellowing of the skin and eyes. Check out all the symptoms of hemolytic anemia.
Ribavirin can cause serious allergic reactions that require immediate medical attention. Therefore, you should stop treatment with ribavirin and seek the nearest emergency room if you experience symptoms such as difficulty breathing, cough, chest pain, feeling of a closed throat, swelling in the mouth, tongue or face, or hives. Know how to identify the symptoms of an allergic reaction.
Who shouldn’t use
The use of ribavirin is not indicated in the following situations:
- Children under 3 years old;
- Breastfeeding women;
- History of severe heart disease, severe liver disease or severe cirrhosis;
- Blood disease such as sickle cell anemia or thalassemia;
- Allergy to ribavirin or any component of the capsules.
Furthermore, ribavirin should not be used during pregnancy, as it can cause fetal malformations, in addition to increasing the risk of miscarriage or death of the baby. Therefore, the doctor must request a pregnancy test before starting treatment with ribavirin, to assess whether it is safe to start using it, in addition to also recommending the use of two contraceptive methods during treatment and at least 7 months after finishing ribavirin treatment.
For men of childbearing age, measures must also be taken to avoid getting their partner pregnant, as it is not known whether ribavirin present in sperm can cause defects in the fetus. Therefore, the man must use condoms throughout the treatment and for up to 7 months after the end of the treatment, and the partner must also use effective contraceptive methods.
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